Individual
STEPHEN LEWIS PIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 EAST NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1421
Mailing address
P.O. BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1421
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35051584P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000378393
ANTHEM BLUE SHIELD
—
05
—
0864417
—
OH
05
—
200176340
—
IN
05
—
64958440
—
KY
Enumeration date
11/23/2005
Last updated
02/01/2011
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